Healthcare Provider Details

I. General information

NPI: 1740307701
Provider Name (Legal Business Name): TROYCE SOLLEY ATC, LAT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 S CONGRESS AVE
AUSTIN TX
78704-6425
US

IV. Provider business mailing address

7707 S I H 35 APT 524
AUSTIN TX
78744-5521
US

V. Phone/Fax

Practice location:
  • Phone: 512-416-5802
  • Fax:
Mailing address:
  • Phone: 512-426-1717
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT3046
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: